Up to 50 per cent of patients undergoing coronary angiography for suspected angina with evidence or not of myocardial ischemia have non-obstructed coronary arteries [1], a condition which is classified under the definition of “angina with non-obstructive coronary arteries” (ANOCA) [2]. In these patients an invasive functional assessment in the Cath Lab identifies endotypes by measuring coronary flow reserve (CFR) and index of microvascular resistance, to assess the presence of microvascular angina (MVA) [2] along with the intracoronary acetylcholine provocative test to detect the occurrence of epicardial or microvascular spasm.
